<include file="public@header" />
</head>
<body>
	<div class="wrap">
		<form method="post" class="form-horizontal js-ajax-form margin-top-20" action="">
			<div class="form-group">
				<label for="input-home_no" class="col-sm-2 control-label"><span class="form-required">*</span>房间号</label>
				<div class="col-md-6 col-sm-10">
					<input type="text" class="form-control" value="" required id="input-home_no" name="home_no">
				</div>
			</div>
			<div class="form-group">
				<label for="input-address_name" class="col-sm-2 control-label"><span class="form-required">*</span>详细地址</label>
				<div class="col-md-6 col-sm-10">
					<input type="text" class="form-control" value="" required id="input-address_name" name="address_name">
				</div>
			</div>
			<div class="form-group">
				<label for="input-from_to" class="col-sm-2 control-label"><span class="form-required">*</span>去向</label>
				<div class="col-md-6 col-sm-10">
					<input type="text" class="form-control" value="" required id="input-from_to" name="from_to">
				</div>
			</div>
			<div class="form-group">
				<label for="input-company" class="col-sm-2 control-label"><span class="form-required">*</span>公司名称</label>
				<div class="col-md-6 col-sm-10">
					<input type="text" class="form-control" value="" required id="input-company" name="company">
				</div>
			</div>
			<div class="form-group">
				<label for="input-corporation" class="col-sm-2 control-label"><span class="form-required">*</span>法人</label>
				<div class="col-md-6 col-sm-10">
					<input type="text" class="form-control" value="" required id="input-corporation" name="corporation">
				</div>
			</div>
			<div class="form-group">
				<label for="input-start_time" class="col-sm-2 control-label">合同开始时间</label>
				<div class="col-md-6 col-sm-10">
					<input class="form-control" type="date" name="start_time" id="input-start_time"
						   value="{:date('Y-m-d')}">
				</div>
			</div>
			<div class="form-group">
				<label for="input-end_time" class="col-sm-2 control-label">合同结束时间</label>
				<div class="col-md-6 col-sm-10">
					<input class="form-control" type="date" name="end_time" id="input-end_time"
						   value="{:date('Y-m-d')}">
				</div>
			</div>
			<div class="form-group">
				<label for="input-phone" class="col-sm-2 control-label"><span class="form-required">*</span>手机号</label>
				<div class="col-md-6 col-sm-10">
					<input type="tel" class="form-control" value="" required id="input-phone" name="phone">
				</div>
			</div>
			<div class="form-group">
				<label for="input-email" class="col-sm-2 control-label"><span class="form-required">*</span>邮箱</label>
				<div class="col-md-6 col-sm-10">
					<input type="email" class="form-control" value="" required id="input-email" name="email">
				</div>
			</div>
			<div class="form-group">
				<label for="textarea-remark" class="col-sm-2 control-label">备注</label>
				<div class="col-md-6 col-sm-10">
					<textarea name="remark" class="form-control" id="textarea-remark" rows="3"></textarea>
				</div>
			</div>
			<div class="form-group">
				<div class="col-sm-offset-2 col-sm-10">
					<button type="submit" class="btn btn-primary js-ajax-submit">{:lang('ADD')}</button>
				</div>
			</div>
		</form>
	</div>
<script src="__STATIC__/js/admin.js"></script>
</body>
</html>